Culturally-Tailored Health Literacy: A Pilot Study of VHV-Led Cannabis Harm Reduction Under Nursing Supervision in Rural Northern Thailand.

Thailand's cannabis policy transition created a knowledge vacuum regarding the boundaries between authorized medicinal use and non-medical consumption, thereby increasing misuse risks. This study evaluated a culturally-tailored medicinal cannabis health literacy program delivered by Village Health Volunteers (VHVs) under public health nursing supervision as a community-based harm reduction strategy. An exploratory sequential mixed-methods design was employed in Northern Thailand. Phase 1 surveyed baseline health literacy ( n = 462 ). Phase 2 involved focus groups to co-design the intervention based on initial findings. Phase 3 was a quasi-experimental pilot study comparing an experimental group ( n = 25 ) with a control group ( n = 25 ) at a 3-month follow-up. Baseline findings showed 72.8% of the community had inadequate cannabis health literacy. Post-intervention, the experimental group achieved a significantly higher overall health literacy score than the control group ( p = 0.016 ), primarily accounted for by superior scores in information access ( p = 0.021 ), communication ( p = 0.024 ), and self-management ( p = 0.025 ). A culturally adapted program delivered through trusted VHV infrastructure, managed within a nursing supervisory framework, provides a promising proof of concept for establishing superior cannabis-related literacy compared to standard community care. This model offers a replicable blueprint for community-based prevention in response to evolving cannabis policies globally.